Health clinics to merge, avoiding shutdown

Fiscally troubled Foothill Community Health Center, facing closure, will unite with Tri-City Health Center

To avoid the shutdown of a major San Jose-based health care resource, two clinics in the East Bay and South Bay will merge to form one of the largest federally recognized community health centers in Northern California.

Foothill Community Health Center, which serves around 65,000 people from Milpitas to Gilroy, will merge with the TriCity Health Center based in Fremont, which serves around 25,000 people in Southern Alameda County, the organizations have announced.

The new combined center will be named Bay Area Community Health, according to a statement issued Friday.

The decision to merge was made in January, as Foothill in late 2019 was facing the prospect of closing its doors for good after a few years of fiscal mismanagement, according to Daniel Winokur, associate CFO of Bay Area Community Health.

Winokur said the shuttering of Foothill, which operates 13 sites around Santa Clara County and serves a majority of people below the federal poverty line, would have been a “deep disaster” in the region.

“This thing that is incredibly valuable was potentially going to die, and tens of thousands of people were going to have no doctor to go to. … It is not an exaggeration to say that people’s lives would have been cut short by that,” he said.

“Instead of that happening, not only are those services going to continue, they’re going to expand,” Winokur said.

“The clinics in Santa Clara County, people love them, and the waiting rooms are full, and we want to add services and expand them,” he said, with a focus

“Tens of thousands of people were going to have no doctor to go to . ... It is not an exaggeration to say that people’s lives would have been cut short.” — Daniel Winokur, associate CFO of the combined Bay Area Community Health center

on behavioral health needs, as well as beefing up other services, such as primary care, vision, dental and chiropractic.

Winokur said Foothill was having trouble over the past three years getting “qualified technical expertise in financial management and compliance,” which led to costly mistakes, such as billing the government and insurance providers for certain kinds of patient visits that weren’t qualified for reimbursement.

“By the time we got to 2019, it became clear that Foothill was really not going to be able to survive on its own, and that’s what led to the strategic partnership with Tri-City,” he said.

The agencies serve a wide swath of people, many disadvantaged, from different backgrounds in both the South Bay and the East Bay, but the large majority of each health center’s clients are at or below 200% of the federal poverty line.

For one person, 200% of the poverty line means annual income is no more than around $25,520.

Winokur said more than half of Foothill’s clientele identify as Hispanic or Latino, and more than half of the clients also don’t speak English as a first language. In the Tri-City region, about 37% of clients identify as Asian, and about 36% identify as Hispanic or Latino.

Most clients have some form of health insurance, Winokur said, but both agencies treat anyone regardless of ability to pay.

While community health clinics around the region were hit hard by the COVID-19 pandemic, forcing some to lay off workers or furlough them, Winokur said Tri-City and Foothill have received a combined $11.5 million in loans from the federal Paycheck Protection Program to stay afloat and have transitioned to a lot of telehealth appointments amid declining patient visits.

They also have received more than $6.6 million in a mix of federal, county and private funds for COVID-19 testing and response, which has allowed them to offer thousands of COVID-19 drive-thru and walk-up tests to date.

When combined, the larger single agency will be able to garner higher reimbursement rates for many patient visits, which will more than help make up for lost ground due to prior billing issues within Foothill.

Winokur said that critical change will bring in revenue to the nonprofit to expand services and improve patient experiences by spiffing up clinic spaces.

The organizations also are working out solutions on the fly to care for patients in person during the pandemic, for things like teeth cleaning and immunizations, which can’t be done remotely and often can’t be delayed, Winokur said.

The changes include special screenings, negative air pressure rooms, dividers between dental work stations, and a system to allow patients to check in for appointments from their car.

“We’re putting in all these changes relative to COVID, but we along with everybody else are on the front lines of trying to figure this out,” Winokur said. “But the future is still a little bit unknown.”